Transcript
Dr. Mark Hyman (0:00)
Coming up on this episode of the Doctor's Pharmacy. But your thyroid gland is important to understand and take care of, to love and figure out often can be fixed. I had thyroid issues when I was really sick with chronic fatigue, but then it all corrected. If you're a regular listener, you know that I often talk about the gut being central to your whole body, health and the key to living those hundred healthy years. And this includes your skin thanks to a fascinating connection known as the Gut Skin Axis. The state of your gut can influence your skin's health and appearance, reflecting what's happening inside your body that that is where seeds DS01 daily symbiotic can be so effective. DSO1 is more than just a probiotic for digestive health. 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Hi, I'm Dr. Mark Hyman, a practicing physician and proponent of systems medicine. A framework to help you understand the why or the root cause of your symptoms. Welcome to the Doctor's Pharmacy. Every week I bring on interesting guests to Discuss the latest topics in the field of functional medicine and do a deep dive on how these topics pertain to your health. In today's episode, I have some interesting discussions with other experts in the field. So let's just jump right in. What is a thyroid function? What is your thyroid gland? It's this little gland in your throat, and it's. Think of it as your overall metabolic regulator. It really controls everything. It's like your motor. It's like the, you know, in terms of the RPM on your engine. So, you know, some. Some things like a golf cart or something, have a governor. And you can only go so fast. It's little like that. So if it's slow, your whole system slows down. If it's faster, whole system speeds up. That's hyperthyroid, not that common, but it can be a problem for some people. But low thyroid or hypothyroid function is really common. And it. And your thyroid gland produces hormones, T4, which is the inactive thyroid hormone. And your brain produces something called tsh, which tells your thyroid to make more thyroid hormone. If it's low or if you have too much thyroid hormone, your TSH goes down. So it's a way we sort of track things. Now, the inactive hormone is T4 that has to get converted in your body to the active hormone, which is T3. Now, T3 is only about 7% of your hormone, thyroid hormone. But it's really important because it does all the work. It actually binds to the nuclear receptors that then translates into gene expression, into all these downstream metabolic effects, and it sends these messenger needed to your DNA to turn up your metabolism. There's not fat burning in your mitochondria to basically get all systems go. And if you have a good T3 level, your cholesterol is in check, your memory is good, your metabolism is good, you stay thin, it helps your hair grow, and it helps your muscles, prevents muscle aches, constipation, and even improves fertility. So if you have your T3 working, it's really great. But the inactive form often doesn't get converted, and there's a lot of reasons for that into T3. And it can be environmental toxins, it can be stress, it can be lack of certain nutrients. So we'll talk about that. Like selenium, it can be overgrowth of yeast. So there's a lot of things that affect this conversion, and often we'll see people with inadequate levels of T3. So the main role of thyroid is to stimulate metabolism, and it really affects almost every single function of the body. And it can cause so many weird, vague symptoms that people don't even often identify it because it's like, oh, I'm a little this, a little that, and you don't really, really get it. So. And the main reason it's not diagnosed is it is that the symptoms aren't specific. You know, you're a little achy, you're a little tired, you gain a little weight, your skin's a little dry, you lose a little bit of hair, you're maybe sluggish, you have trouble concentrating, a little depressed. You know, you're, you're maybe a little cold when you know everybody else is warm. You get whole hands and feet. You get, you know, low libido. You might get a little flu retention. Your cholesterol is a little high. These are really nonspecific symptoms that can be caused by many, many things. But when you add it all together and you look at this list, it's like, oh, I have all that. You know, like, that's really a clue that you might have thyroid issues. So taking a thyroid quiz, which is really important, we can link to it in the show notes, gives you a pretty good sense of if you're having a likelihood of having low thyroid. And then you need to do the right testing. Now, the problem is that it's often we call subclinical. So it might not be full blown thyroid disease. But, you know, in functional medicine, we like to think about how do we get to optimal function, not just what's normal. If you look at the normal lab tests, they're often misleading because they're based on a population that may not be healthy. So, you know, the range of, for example, tsh, which is what most doctors look at to check your thyroid, is 0.5 to 5. That's a 10 fold range of what's considered normal. The American College of Endocrinology has lowered the top number to 3.5 or 3. But what's optimal might be 1 or 2 or, you know, 0.5 to 1 or so. What's really optimal is very different than what's, quote, normal. And that's why it's often missed. And doctors will often miss it because they just check the TSH and not the whole panel of tests. It gives you a really comprehensive view. If you just check tsh, it could be normal, but you could still be, for example, having an autoimmune thyroid condition, or you could still have a low T3. And doctors will not check that. They'll only check your other numbers. If your TSH is abnormal, which is really a bad way to go about it. So I think it's really important do a comprehensive thyroid panel which includes TSH free T3, free T4 and thyroid antibodies, thyroid peroxidase and anti thyroid globulin antibodies. Now, a lot of doctors will check thyroid panel on an lab rec. And the old lab recs have very old thyroid panels that use all kinds of antiquated tests, which I still see unfortunately, like T3 uptake and all these weird things that are not really accurate given how sensitive these current new tests are for free T3, free T4 and ultra sensitive THH. And also, you know, if you're really stuck and there's other things going on, there's more advanced tests like thyroid releasing hormone that we can use by using a stimulation test. So we won't get into that. But the key is the basic test should be TSH free T3, free T4, thyroid antibodies, TPO and anti thyroid globulin antibodies. If you get that whole panel and you can see for example, cases where there's high antibodies but normal thyroid testing, those people still need to be treated or you'll see a low T3 but normal TSH. So it's really, really important to do a whole panel. Now. Let's talk about what causes thyroid problems, because why are we seeing so many people with thyroid issues? Is this a genetic defect in human beings? I don't think so. It's really because we are living in a toxic world in many ways. One, environmental toxins are really impactful on the thyroid function. Think of your thyroid as a yellow canary in your body. The yellow canaries were put in coal mines and when the canaries died, the coal miners knew the air was bad. They had to get out of the coal. So the thyroid is like the yellow canary of the body. Very sensitive to pesticides, heavy metals, environmental toxins of all sorts, which are super abundant. And it's 80,000 these compounds in the environment. Only 1% have been tested for safety. They're ubiquitous. The average person is basically a walking toxic waste dump. Dioxin, PCBs, phthalates, DDT, all this stuff is still in us even though it's been banned. Some of this stuff has been banned and most of us can handle it. But it's really important to focus on a identifying these toxins. Heavy metals are a huge factor, particularly mercury and a big factor also stress. You know, there's a deep connection between your adrenals and your thyroid glands. So people who are overstressed, you know, by psychological stress, physical stresses, lack of sleep. Those stresses register in the body directly in terms of adrenal function. And when your adrenal functions low, you often will see a kind of this thyroid function go low. So you're, for example, if you put young soldiers on a forced march, you'll see their thyroid function decrease just because of the stress of an overnight march with carrying a 50 pound pack. And they look like they're hypothyroid even though they're really not. So stresses are a big factor. Another one is gluten. Gluten is a huge factor and about probably 20, 30% in my experience, seeing, you know, thousands of patients and testing them. Everybody who's got low thyroid or antibodies to thyroid, I check their gluten antibodies too. About 20% to 30% of people who have low thyroid function can be a result of gluten sensitivity, their celiac disease or non celiac gluten sensitivity. And it's really important to track because if you keep eating gluten like you, or you keep having mercury, your thyroid is just not going to work. And this can affect about 10 to 20% of the population. So it's really common in terms of the inflammation in the thyroid. Also nutrient deficiencies. You know, thyroid function needs, you know, iodine to make the thyroid hormone. You need selenium to convert T3 to 4. You need vitamin D and vitamin A to have it bind on the nucleus to work and do its thing. You need the right omega 3 fats and many other nutrients to help optimize thyroid function. So what do you do if you think you might have low thyroid? What steps should you take? Well, first do the symptoms check. Look at the questionnaire, the link, the things that I just mentioned. You can kind of do a mental checklist or you can fill out the thyroid questionnaire we're going to link to in the show notes. That's the first thing. And if there's some suspicion, you need to get the right tests and there's a lot of ways to do that. Right now you have to ask your doctor. There are labs that are coming online like function Health where you'll be able to into your own ordering of tests, which is important, but you want the full spectrum. Like I said, TSH free, T3 free T4 thyroid antibodies, TPO and anti thyroid antibodies. You also want to check for celiac with our gluten sensitivity, with the aminated glide, anti gliding antibodies, tissue transglutaminase antibodies. We'll write all this up in the show notes, keep track of it. We might also want to do a heavy metal test. Look for heavy metals with a DMSA challenge test to look for urine toxic metals. After a six hour collection. There are tests to look at pesticides and chemicals in your body through urine testing. Sometimes I'll do that, but we can all. We're all pretty exposed, want to reduce our exposures. And you can do that by going to Ewg Dawg and learning about how to reduce your exposures across skincare products, household products, food products. Vitamin D plays a huge role. If you're vitamin D deficient, you want to see that for sure because by correcting that it'll help your thyroid work better. You can check for selenium levels. Often there's selenium deficiencies, iodine deficiencies, we can measure that as well. So we do a real close inventory of nutritional status. That's how I kind of evaluate it. So what do I do to help fix thyroid function? Well, first you deal with all the causes, gluten, stress, the microbiome, we didn't really talk much about that. But that can play a role in generating inflammation that causes problems and obviously environmental toxins. And then what do you do to optimize your thyroid function? Well, first thing is get eat the right foods that support your thyroid function. My favorite is seaweed. Seaweed is full iodine minerals. It's great for your thyroid. Fish also great sardines, wild salmon, mackerel, herring. Also fish contains a lot of iodine omega 3 fats which you also get from the same foods. Make sure you get vitamin D. Probably need a supplement. Herring, mackerel or great source of vitamin D. Mushrooms like porcini mushrooms. But it's hard to get enough. So sunlight and obviously checking your vitamin D and taking vitamin D also you can get your vitamin A which is important for thyroid function from dandelion greens, mustard greens, a dark green, leafy vegetables, liver organ meats also if you like that. I do. Also selenium is super important and that can come from herring, scallops, smelt, which a tiny little fish. Brazil nuts probably are the best Source. You get 50 micrograms of purpose on that. So I would, I would, I would make sure you. We have plenty of those foods and the things you want to avoid if you're having thyroid function issues. Well, I would get off of gluten, dairy, which are inflammatory for most people. And processed soy. If people are eating a lot of processed soy, it can affect thyroid potentially. Also kale and some of the cruciferous vegetables. If you juice a lot of kale, for example, it can cause a problem. I once read a report of someone who I thought of the broccoli family vegetables was good for them. And they ate 2 pounds of bok choy raw every day. Now if it's raw, it's worse. So don't eat raw cruciferous vegetables that much. And she went into a hypothyroid coma. So that's an extreme case. But if you're juicing raw kale every day, you can get into trouble. Then what should you do in terms of supplements? A good multivitamin that contains selenium, iodine, zinc, vitamin A, and then you might want to add in vitamin D and omega 3 fats. If your adrenals are stressed out from chronic long term stress, you want to deal with that through regular circadian rhythm, lifestyle management, getting sunlight exposure in the morning for 20 minutes, waking and sleeping at the same time every day, having meditation practice, yoga, deep breathing, all the lifestyle practices for resetting your adrenals. And then you can use herbs like rhodiola, Siberian ginseng, various adaptogenic mushrooms. This is really a way to kind of boost your adrenal function. And then if you're stuck, you know, you kind of might need to work with Dr. To optimize what you need in terms of thyroid treatment and adrenal treatment. So if you, let's say you need thyroid replacement and a lot of people do, sometimes you can get away without it. But if you, if you've done all the things that I just said and your thyroid is still not optimized, then you need to know what should you take? Now the traditional approach is everybody should take Synthroid, which is levothyroxine or T4. And that works for some people, but many people it doesn't. And they'll be partially treated. And if you check the T3, their T4 will be good because you're getting it, but their T3 will be low. And I think it's better to use a bioidentical form of thyroid, which is actually how all the hormones were first developed. And it may sound kind of weird or gross, but it comes from pig thyroid, porcine thyroid, and it's very similar or almost identical to ours. And it contains T4, T3, something called T2, which is really unusual that people might not know about, which actually helps metabolism. Metabolism and is very important. And so most doctors just assume that synthet will get converted, but it really doesn't because all the Pesticides, environment, the heavy metals, the stress, the food sensitivities, gluten, deficiencies of nutrients. 100% of us have toxins in our body. So it's better to just take a combination bioidentical thyroid replacement. And I usually use armor thyroid. In the old days it wasn't well manufactured and so the dose was variable. But now it's really well controlled and a lot of doctors don't like it. But I encourage you to think about trying it because it really can help. You need to check your thyroid. If you change your thyroid or put yourself on thyroid or take thyroid, you need to check it probably about six weeks after you take your whatever dose you're on and then you can see how it's working and then adjust it. If you take too much, you want to be careful because you can take too much. That can cause bone loss. It can make you hyper, insomnia, palpitations, so you have to track it. But your thyroid gland is important to understand and take care of, to love and figure out. And it's and it often can be fixed. I had thyroid issues when I was really sick with chronic fatigue, but then it all corrected. 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